The following is a transcript of an interview with former FDA Commissioner Scott Gottlieb that aired March 21, 2021, on "Face the Nation."
MARGARET BRENNAN: We go now to former FDA commissioner Dr. Scott Gottlieb. He sits on the board of Pfizer as well as Illumina, and he joins us from Westport, Connecticut. Good morning to you.
DOCTOR SCOTT GOTTLIEB: Good morning.
MARGARET BRENNAN: We- when we spoke last Sunday you were very concerned about New York City and this new variant, B.1.526 that's been circulating. You said you would be very cautious. What do we know now?
DR. GOTTLIEB: Well, I'm still concerned about it. We're seeing cases and hospitalizations go down across New York, so that's a good- good sign. Although testing has also plummeted. When you look in certain parts of New York, Brooklyn, parts of Queens, parts of Staten Island, the positivity rate is approaching 15%. So you're seeing a lot of infection surging in pockets of New York City. What we don't understand with 1.526 is whether or not people are being reinfected with it and whether or not people who might have been vaccinated are now getting infected with it. One of the concerns about this particular variant is that it has that mutation that's also in the South African variant, in the B.1.351 variant, that we know in certain cases is causing people who have already had coronavirus to get reinfected with it. And so the question is- is whether 1.526 is responsible for some of the increases that we're seeing in New York right now and whether this is the- the beginning of a new outbreak inside the city. We're just not very good right now at collecting the cases and linking it back to the clinical experience. So we need to step in much more aggressively and start sequencing cases, especially people who report that they either were previously vaccinated or already had COVID.
MARGARET BRENNAN: When you say we, you mean the CDC. Who needs to do that?
DR. GOTTLIEB: The CDC, I mean, they need to work with the New York City Public Health Department, but the city alone isn't going to have the resources to do this on a systematic basis. I think they're going to step in and start to do that. But they need to be aggressively marketing to doctors, asking doctors to come forward and report cases where they're seeing situations where people who were previously infected with COVID may be getting infected. We don't know that's happening. But anecdotally, some doctors are reporting that now and that could potentially explain why you're seeing an upsurge in cases. It could just be that, you know, 1.526 and B.1.1.7 is becoming more prevalent and that's responsible in and of itself. But you want to make sure that it's not reinfecting people. Right now, more than 50% of the infections in New York we know are with variants. And B1- one- B.1.526 is the most prevalent variant right now. We're probably undercounting it because we're biasing our- our screening, our sequencing towards B.1.1.7. So we're probably missing cases of B.1.526 right now. It's probably more prevalent than what we're detecting.
MARGARET BRENNAN: When it comes to B.1.1.7, the variant first detected in the UK, Dr. Fauci said this week it's about 30% of US infections and it's, what, 50% more transmissible? It's also potentially more lethal. When you see these pictures of these spring break gatherings in Florida and elsewhere, does that make you rethink your projections here and worry about a fourth wave?
DR. GOTTLIEB: Well, I don't think we're going to have a fourth wave, I think what we're seeing around the country is parts of the country that are plateauing, and we're seeing upticks in certain parts of the country. I think the fact that we have so much prior infection, 120 million Americans have been infected with this virus, the fact that we've now vaccinated, we've gotten one shot in at least 70 million Americans, even if you account for the fact that maybe about 30% of the people being vaccinated previously had COVID, we're talking about some form of protective immunity in about 55% of the population. So there's enough of a backstop here that I don't think you're going to see a fourth surge. I think what you could see is a plateauing for a period of time before we continue on a downward decline, in large part because B.1.1.7 is becoming more prevalent, in large part because we're pulling back too quickly with respect to taking off our masks and lifting the mitigation. But I still don't think that it's going to be enough to create a true fourth wave. If you look at in Europe, where they're having a true fourth wave, they've only vaccinated one in- one in nine adults. Here in the US, we've vaccinated one in three. In the U.K., which is seeing consistent declines, they've vaccinated one in two. So the vaccination is going to be a backstop, and we're continuing to vaccinate about three million people a day right now.
MARGARET BRENNAN: Well, Mayor Garcetti of Los Angeles was essentially saying that his hunch, it sounds like, is that these variants of concern in California already ripped through his population, that that's just what they saw with the epidemic in January. What do you think of his thesis?
DR. GOTTLIEB: That's probably right. The- the two variants that we're tracking in California probably have already become epidemic in that part of the country, and they probably have a level of prior immunity in the population that you're not going to see a true fourth wave. You might see a tick up, but once you get 50, 60% of the public with some form of immunity, which is where we are in many parts of the country, there's not a lot of people left to infect. And again, we're vaccinating against that. So we're continuing to put protective immunity into the population. I do think that the fact that we've sort of taken our foot off the brake a little too early here, March was always going to be a difficult month. People want to lean forward, but we really should have waited till April. The fact that we've done that now probably means that we're probably going to plateau. Maybe we'll see an uptick in certain parts of the country. The only thing that can be a real game-changer here is if we have a variant that pierces prior immunity, meaning it reinfects people who've either already been infected or who have been vaccinated, like the 1.351 variant, older P.1 variant, the one in Brazil. Now, those variants aren't epidemic in the US. They're just sporadic. But 1.526, the reason why people are concerned about it, including me, is it could be such a variant. We need to figure it out. We don't know right now. We need to get better at determining these things.
MARGARET BRENNAN: Dr. Gottlieb, thank you for your analysis. We'll be back in a moment.
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